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Saturday, May 31, 2014

(Note: two days after my last post I underwent a robotic prostatectomy at Penn Presbyterian Medical Center in Philadelphia. The surgery was the right choice for me, but every prostate cancer case is different. I have learned it is a very complex disease. The preferred treatment will vary from person to person according to the stage of the disease, the patients age, and other factors. Please, please do not assume that my decision on the treatment for my cancer is the right decision for you or a loved one. Trust me: it is a process to arrive at the proper treatment. For those of you interested in seeing a robotic surgery, click here to see Dr. Lee perform one in Seoul, South Korea. Be advised that the video contains graphic material of an actual surgery, and may not be suitable for all viewers. I will work my way up to posting about my surgery and ongoing recovery, but for now I'm going to pick up where I left off: dealing with the diagnosis and its impact on my family and me.)

Timing is Everything...

Timing. That's the theme of this post.

From the disease standpoint, the timing has been incredibly good. My prostate cancer pre-surgery indicated that I had a moderately aggressive but locally confined tumor. The clinical stage (meaning the assessment of the tumor by way of all the evidence gathered before surgery) was somewhere in the Stage II spectrum. There are a wide range of possibilities under Stage II, and until a prostate is removed and examined by a pathologist there is a fair amount of wiggle room on a tumor's actual staging. The pathologist issues the final pathological staging of the tumor, and that may vary from the clinical staging. A tumor may be downgraded or upgraded, based on all the final reports and the findings of the surgeon during the procedure. (Click here for more information on prostate cancer staging)

My timing as far as getting the physical that started this whole shebang was also good. My previous PSA blood test was done in July of 2011. The PSA was an unremarkable 1.78 (PSA is a protein produced by the prostate gland. High PSA levels may indicate prostate cancer, however there are other reasons a man's PSA level may be elevated.) When my PSA was tested in February of 2014, it was 6.17 and that got my doctor's attention. It wasn't so much the higher number, but the rate of change over that relatively short period of time. That rate of change, called PSA velocity, was another indicator something might well be going on in my prostate.Long story very short, that is what led me to the biopsy, which led me to the phone call that started all these blog posts when I hung up and realized I had cancer.Which takes us back to timing.How does one tell their family they have cancer? More precisely, when?When I hung up the phone after getting the news, I realized I had to make decisions. Who needed to know? Who didn't? And when to tell them? And in what order?My wife, of course, was at the top of the list. No one else would be told until I broke the news to her. Next would come my children, then my siblings and a very, very few others. That would be it initially.So there, on this beautiful Thursday afternoon, I had to decide when to tell my wife. While I was pondering this, she texted me from work to bring her an iced coffee. Off I went to Dunkin, then down the road a bit to the daycare she works for.

As I waited for her at the door, I realized this was the wrong time to say anything. You don't hand someone a coffee and say: "Here you go. Extra cream & sugar. I've got cancer. I had them put a shot of caramel in there, too. Enjoy the rest of your shift!"

No, this wasn't the moment. It would be horrible, horrible timing to drop that little bombshell on her at work. I would wait and tell her later. She wasn't expecting the results of my biopsy until the next day, so I just handed her the coffee and left and she suspected nothing.When I picked her up from work, I realized I couldn't tell her in the car. Again, that would be horrible timing: "Hi, honey, how was work? Was it a good shift? The biopsy was positive. Wanna do burgers or pasta tonight?"We drove home in silence.As I prepped dinner, I decided telling her before we ate would also be horrible, horrible timing. Nothing kills that evening appetite faster than a cancer diagnosis. It would have to wait until after supper.

But after supper, I realized that I'd better wait a while. Nothing brings dinner back up faster than hearing your spouse has cancer.

No, no... I'd wait an hour or two, after my daughter, who always goes off somewhere in the evening to visit friends or catch a movie, left the house. That would be the perfect time to break the news to my wife. Then we could plan when to tell our kids.Only my daughter stayed in that evening and the three of us sat in the living room watching god knows what on television for the next couple of hours. And I patiently waited for my daughter to go to bed, because that would be the best time, and as I keep saying, timing is everything.Ten minutes or so after my daughter went to bed, I broke the news to my wife. Here's a condensed version of what transpired:She: You tell me this now? How can you tell me this now, right before bed? What horrible, horrible timing!Me: Well, telling you at work didn't seem right. Telling you on the ride home didn't seem right; I didn't want you jumping outta the car. Telling you before dinner would have ruined your appetite. Telling you after dinner might reintroduce you to what you just ate. I wanted to tell you before I told our daughter, so that we could tell her together.She: But Jesus, right before bed?

Me: When, then? First thing in the morning? That's no way to start the day. "...Good morning, honey, I've got cancer, time to go to work. Have a great day!"She: But...Me: When, exactly, is it a good time to tell someone you have cancer?Silence, from both of us. You see, we'd just stumbled headlong into another of the laws of the Universe: There is no good time to tell someone you have cancer.

Monday, May 5, 2014

For the millions* of women who have asked me: Boxers or Briefs? Depends. For a little while.* The author is prone to exaggeration.

Reality slaps me in the face at Walmart. Reality.I hate that ##$%#$!!

I think I wrote at some point that I'd have the occasional down day. Well I had one yesterday, though it likely wasn't obvious to very many people.I had a fantastic Saturday, for the most part. I helped put together a big political event. Perhaps the biggest thing I've ever done. The only down side of the event is that my apolitical loved ones would rather stick needles in their eyes than attend anything political, so I was pretty much on my own. I respect that, but there was still a part of me that wanted them to see what it meant to me to put something like this together before I enter a period of ...oh I don't know ...I suppose the polite word is "unpleasantness."Yeah, we'll go with that. Unpleasantness.So I spent half the day on the event, starting with final prep work at 4:30AM. Then came the event itself. I finally headed home around noon, where I found the grandchildren visiting. After about an hour or so with them, I headed off to work. I can honestly say that when I hit the sack that night, still in a pretty fair mood, I was probably more tired than I've been in decades. Just worn to a nub. I wanted to sleep until at least 7AM.Instead, the alarm in my phone went off around 4AM and long story short, I was up for the day. And because I had too little sleep while already exhausted, I set myself up for brooding.So there I am, in the wee hours, exhausted and unable to fall back asleep. I ended up working on home finances until it was time for church. Finances were a downer Sunday morning. It is becoming apparent that even with good insurance, getting sick is going to be expensive. Church put me on the rebound, as it always does, especially on Sundays like this one when I am "on duty" as a Eucharistic Minister.Yet even here, my thoughts wandered to the morbid. I realized that if my upcoming surgery (more on that in another post) went horribly wrong, this could be the last time I would experience the joy of receiving and giving Communion. I know the chances of something going that wrong are small, but I also know one of the profound, unshakeable laws of the Universe: Shit happens.Well, that self-pity train just kept rolling. I started thinking about all the things that would blow up if I wasn't there to keep them going. I won't list them, but there were a kajillion of them racing through my head. Then I recalled another of the laws of the Universe: The Universe will go on without you, dumbass.I suppose that is so. After all it was here first. We're all just visiting a bit.With great effort, I pulled myself out of the doldrums. I went over to Wallyworld after Mass to buy coffee and some other odds and ends. I was feeling pretty good. Saw a portable ice machine, and envisioned myself on the deck plopping fresh ice cubes into my beverage of choice. I could almost smell burgers cooking on the charcoal grill, and the gentle aroma of wing sauce wafting past me from the kitchen.Yes, life was good. Keep that chin up! I told myself.I turned down an aisle and found myself in front of the incontinence supplies. Depends underwear for men. Various underwear pads. (They call those pads "guards." I think it is so men can imagine them as a sort of offensive line protecting the star quarterback. It's a lot better, I suppose, then realizing they are there to keep you from earning a new nickname: Dribbles.)

Too much reality. Far too much. I stood there looking at all the products. There's a pretty impressive collection out there for dribblers and soon-to-be dribblers.And yet, that dose of reality calmed me down. Yes, there are some unpleasant days ahead.So what.I will just find myself something else to dive into and I'll deal with what comes. I've spent 56 years doing that and it has worked out pretty well so far. I have a knee that I shouldn't be able to walk on and I've done thousands of door-to-doors on it. I am deaf, but I can hear again. I'm ugly and ...well, okay, that is what it is.So sayonara. Signing off for today.